ABILENE DIAGNOSTIC CLINIC, PLLC
NPI 1346242567
Specialist in Abilene, TX

NPI Status: Active since June 01, 2005

Contact Information

1665 ANTILLEY RD
# 200
ABILENE, TX
ZIP 79606
Phone: (325) 793-5375
Fax: (325) 793-5384

NPI Profile Information
Primary Taxonomy
Group Taxonomy
Insurance Plans Accepted
Authorized Official
CLIA Information
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Organization
Specialist
Accepts Insurance
CLIA Number: 45D2180205
CLIA Cert. Type: Physician Office
CLIA Exp. Date: 03-09-2026

About ABILENE DIAGNOSTIC CLINIC, PLLC

This page provides the complete NPI Profile along with additional information for Abilene Diagnostic Clinic, Pllc, a provider established in Abilene, Texas operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1346242567 assigned on June 2005. The practitioner's primary taxonomy code is 174400000X. The provider is registered as an organization and their NPI record was last updated 3 years ago. Abilene Diagnostic Clinic, Pllc operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's is doing business as Abilene Diagnostic Clinic, Pllc. The authorized official of this NPI record is Andrew Kouba (Ceo/authorized Official)

NPI: 1346242567
Provider Legal Name: PRIVIA MEDICAL GROUP WEST TEXAS, PLLC
Other Organization Name: ABILENE DIAGNOSTIC CLINIC, PLLC
Other Name Type: Doing Business As (3)
Entity Type: Organization
Location Address: 1665 ANTILLEY RD # 200 ABILENE, TX 79606
Location Phone: (325) 793-5375
Location Fax: (325) 793-5384
Mailing Address: PO BOX 5409 ABILENE, TX 79608
Mailing Phone: (325) 437-8655
Mailing Fax: (325) 793-5384
Is Sole Proprietor?: No
Is Organization Subpart?: No
Enumeration Date: 06-01-2005
Last Update Date: 09-07-2022
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Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Specialist
Taxonomy Code: 174400000X
Type: Other Service Providers
Taxonomy Description: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Ambetter from Arizona Complete Health

Choice Bronze HSA - HMO
Choice Bronze HSA + Vision + Adult Dental - HMO
Clear Silver - HMO
Complete Gold - HMO
Complete Gold + Vision + Adult Dental - HMO
Complete Silver - HMO
Complete Silver + Vision + Adult Dental - HMO
Elite Gold - HMO
Elite Gold + Vision + Adult Dental - HMO
Everyday Bronze - HMO

Ambetter from Arkansas Health & Wellness

Choice Bronze HSA (QualChoice) - POS
Complete Gold - PPO
Complete Gold + Vision + Adult Dental - PPO
Complete Silver (QualChoice) - POS
Connected Silver - PPO
Connected Silver (QualChoice) - POS
Connected Silver (QualChoiceLife) - PPO
Connected Silver + Vision + Adult Dental - PPO
Elite Bronze - PPO
Elite Bronze + Vision + Adult Dental - PPO

Ambetter from Louisiana Healthcare Connections

Complete Gold - EPO
Complete Gold + Vision + Adult Dental - EPO
Elite Bronze - EPO
Elite Bronze + Vision + Adult Dental - EPO
Elite Gold - EPO
Elite Gold + Vision + Adult Dental - EPO
Elite Silver - EPO
Elite Silver + Vision + Adult Dental - EPO
Everyday Bronze - EPO
Everyday Bronze + Vision + Adult Dental - EPO

Ambetter from Superior HealthPlan

Clear VALUE Silver - HMO
Complete Gold - EPO
Complete Gold + Vision + Adult Dental - EPO
Complete Silver - EPO
Complete Silver + Vision + Adult Dental - EPO
Complete VALUE Gold - HMO
Everyday Gold - EPO
Everyday Gold + Vision + Adult Dental - EPO
Focused Silver - EPO
Focused Silver + Vision + Adult Dental - EPO

Ambetter Health

Complete VALUE Gold - HMO
Complete VALUE Silver - HMO
Elite VALUE Bronze - HMO
Focused VALUE Silver - HMO
Standard Expanded Bronze VALUE - HMO
Standard Gold VALUE - HMO
Standard Silver VALUE - HMO

Ambetter of Oklahoma

Elite Bronze - PPO
Elite Bronze + Vision + Adult Dental - PPO
Elite Gold - PPO
Elite Gold + Vision + Adult Dental - PPO
Everyday Bronze - PPO
Everyday Bronze + Vision + Adult Dental - PPO
Everyday Gold - PPO
Everyday Gold + Vision + Adult Dental - PPO
Focused Silver - PPO
Focused Silver + Vision + Adult Dental - PPO

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name: ANDREW KOUBA
Authorized Official Title: CEO/AUTHORIZED OFFICIAL
Authorized Official Phone: (325) 437-8645

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier	Type / Code	Identifier State	Identifier Issuer
1306102-02	MEDICAID (05)	TX

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number: 45D2180205
Facility Type: Physician Office
Certificate Effective Date: March 10, 2024
Certificate Expiration Date: March 09, 2026
Laboratory Director: JASON ACEVEDO
Certificate Type: Certificate of Waiver
Certificate Type Description: This CLIA certificate is issued to Abilene Diagnostic Clinic, Pllc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	3	4	6	2	4	2	5	6	7
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	3	8	6	4	4	4	5	12
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 3 + 8 + 6 + 4 + 4 + 4 + 5 + 1 + 2 + 24 = 63
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 63 = 7									7

The NPI number 1346242567 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location

The following 20 providers are registered at the same or nearby location.

MICHAEL WAYNE CHAUVEAUX P.T.

Physical Therapist

1665 ANTILLEY RD
SUITE 120
ABILENE, TX
ZIP 79606

About ABILENE DIAGNOSTIC CLINIC, PLLC

Location Map

Specialty - Primary Taxonomy

Specialist

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

Insurance Plans Accepted

Authorized Official

ANDREW KOUBA

Additional Identifiers

CLIA Information

Reviews for ABILENE DIAGNOSTIC CLINIC, PLLC

NPI Validation Check Digit Calculation

Other Providers at the Same Location

Frequently Asked Questions